恶性肿瘤相关高钙血症临床特征及预后分析  

Analysis in clinical features and prognosis of malignancy associated hypercalcemia

作　　者：詹继东[1] 付强[2] 程黎明[3] 管青[3] 戴宇翃[2] 汤陵[2] 

机构地区：[1]华中科技大学医院内科,湖北武汉430074 [2]华中科技大学同济医学院附属同济医院肿瘤中心,湖北武汉430030 [3]华中科技大学同济医学院附属同济医院检验科,湖北武汉430030

出　　处：《临床荟萃》2014年第1期38-40,共3页Clinical Focus

摘　　要：目的探讨恶性肿瘤相关高钙血症患者的临床特点及预后。方法收集华中科技大学同济医学院附属同济医院肿瘤中心2007年1～6月收治的603例恶性肿瘤患者的血清总钙、白蛋白、校正血钙（游离钙）及相关临床资料，分析其中33例合并高钙血症患者的临床特征及生存状况。同时对33例患者进行生存期随访。观察终点为发现高钙血症后的生存时间。随访时间截止至2012年6月1日。结果恶性肿瘤相关高钙血症的发生率为5．5％（33／603），高钙血症的发生与年龄（P〈0．05）、临床分期（P〈0．01）、血清总钙（P〈0．01）、血清白蛋白水平（P〈0．01）相关。而与性别、肿瘤类型无关。在转移部位上，肺转移（P〈0．05）和骨转移（P〈0．01）与高钙血症相关。33例出现高钙血症患者的生存时间为2～1467天（中位时间96天），至随访截止时间全部死亡。结论恶性肿瘤相关性高钙血症多见于晚期，生存期短，诊断高钙血症应对血清总钙进行校正，以血清游离钙判断为宜。Objective To investigate the clinical features and prognosis of patients with the malignancy associated hypercalcemia. Methods Serum total calcium,serum albumin,corrected calcium （free calcium） and clinical data of 603 patients with malignant tumors were collected in Cancer Center of Tongji Hospital affiliated to Tongji Medical College, Hua Zhong University of Science and Technology from January to June 2007, and 33 patients with hypercalcemia were analyzed in clinical characteristics and overall survival time through the survival period of follow- up. Endpoint was defined in survival time after hypercalcemia was diagnozed. The deadline of follow-up time was June 1,2012. Results The incidence of malignancy associated hypercalcemia was 5.5% （33/603）, the hypercalcemia occurrence was related to age （ P G0.05）, clinical stage （ P〈0.01）, serum total calcium （ P 〈0; 01）, and serum albumin （ P 〈0.01） ,while it was not related to gender,tumor type. Meanwhile,lung metastases （ P 〈0.05） and bone metastases （ P 〈0.01） were associated with hypercalcemia. Tile survival time of 33 cases with hypercalcemia was 2 to 1 467 days （the median survival time 96 days） from observation to follow-up cut-off time. Conclusion Malignancy associated hypercalcemia frequently occurred in advanced tumors and related to the short survival time. Serum free calcium （ corrected calcium ） was suitable rather than the serum total calcium in the diagnosis of malignancy associated hypercalcemia.

关 键 词：肿瘤 高钙血症 临床特征 预后 

分 类 号：R730.43[医药卫生—肿瘤]